New findings from a landmark research study led by Scripps Translational Science Institute (STSI) — a collaborative program between Scripps Health and The Scripps Research Institute (TSRI) — shows a promising new blood test may be useful in helping doctors predict who is at risk for an imminent heart attack.

The unique appearance of circulating endothelial cells in heart attack patients (right) may make them predictors of imminent heart problems. (Credit: Image courtesy of Scripps Health).

Results of the study, titled “Characterization of Circulating Endothelial Cells in Acute Myocardial Infarction,” were published this week in Science Translational Medicine. The study concludes that circulating endothelial cells (CEC) from heart attack patients were abnormally large and misshapen and often appeared with multiple nuclei, which indicates that CECs are promising biomarkers for the prediction of acute ongoing arterial plaque rupture.

“The ability to diagnose an imminent heart attack has long been considered the holy grail of cardiovascular medicine,” said Dr. Eric Topol, the study’s principal investigator and director of STSI. “This has been a tremendous collaboration of two institutions on the research side, three health care systems in San Diego, and a life science industry leader, which has resulted in an important discovery that may help to change the future of cardiovascular medicine.”

The study involved 50 patients who presented to emergency rooms with heart attacks at four acute care hospitals in San Diego. Using different cell isolation platforms, including the Veridex CellSearch System, the researchers found that CEC counts and the cell structural features were dramatically altered in the heart attack population when compared to the healthy control group.

“We are pleased to have collaborated on this important investigational study, said Mark Connelly, PhD, Director, Cellular Research, Veridex. “CellSearch has proven to be a powerful tool for oncology research and the care of metastatic cancer patients. This study highlights the value of accurate rare cell capture and analysis in areas beyond oncology.”

The study was co-authored by physicians and scientists from Scripps Health; STSI; TSRI; Veridex, LLC (a Johnson & Johnson company); Palomar Health; and SharpHealthCare. Funding came from a $2 million grant from the National Institutes of Health.

The findings are significant, as more than 2.5 million U.S. individuals experience a heart attack or ischemic stroke, most commonly the result of obstructive coronary artery disease, according to Paddy Bennett, MD, lead investigator at STSI. If the arteries get abruptly and completely occluded by the buildup of fatty cholesterol, it will cause a massive heart attack that will likely lead to a sudden death, as was the case involving former NBC News Washington Bureau Chief Tim Russert.

Test may be developed for widespread use soon

“With some additional validation, the hope is to have this test developed for commercial use in the next year or two,” said Raghava Gollapudi, MD, who was the principal investigator from Sharp HealthCare. “This would be an ideal test to perform in an emergency room to determine if a patient is on the cusp of a heart attack or about to experience one in the next couple of weeks. Right now we can only test to detect if a patient is currently experiencing or has recently experienced a heart attack.”

This study is an extension of Scripps Health’s leadership in heart care and research. Scripps is currently building the $456 million Prebys Cardiovascular Institute, a center for innovation that will bring together top researchers, physicians and staff. The institute will incorporate leading-edge wireless technologies and individualized medicine for the best in patient care when it opens in 2015.

Annually, more than 55,000 patients receive their cardiovascular care from Scripps, making it San Diego County’s largest heart care provider. Scripps is the region’s only cardiovascular program consistently recognized by U.S. News & World Report as one of the best in the country.